Treating SAD: A Guide to Seasonal Affective Disorder


Treating SAD: A Guide to Seasonal Affective Disorder

A beautiful Asian woman. young women the pensive face looking away thinking of problems sit alone at home, Sad eyes, Winter sadness

Seattle Times calls it the Big Dark. To the rest of us it’s just winter. But whatever you call the five months of the year when cloudy days end with the sun setting before 5:00 pm, the lack of sunlight can be hard to live with. Lots of people get winter blues, but seasonal changes can trigger a type of clinical depression called seasonal affective disorder (with the apt acronym SAD).

“It’s very common. I think a lot of people just self-diagnose and try to tough it out. It’s harder in geographic locations like ours where winters are really long and dark and gloomy. It can be exacerbated, too, by the holidays. The holidays are not a happy time for everybody,” said Lisa Adriance, PhD, clinical psychologist at Western Washington Medical Group.

What is Seasonal Affective Disorder (SAD)?

If the Big Dark is at the root of your low mood, you don’t have to just tough it out until spring, although many people find that their mood improves with the return of longer days. A health professional can help you figure out whether the weather just gets you down sometimes or if you have depression, and they can help you deal with it either way. You can also take steps on your own to start feeling better.

We all feel down sometimes. In contrast to “the blues,” which can also be significant but are often triggered by life events and usually pass on their own, SAD meets the diagnostic criteria for depression.

Depression is a mood disorder that sufferers cannot simply “snap out” of. It is marked by a cluster of symptoms including:

  • low or irritable mood
  • decreased energy
  • loss of interest in normal activities, and
  • changes in appetite and sleep

Depression impacts how we feel about ourselves, our outlook, and our ability to engage productively in life.

SAD can be mild to severe. When symptoms are severe – that is, when they interfere with the ability to function normally, or lead to thoughts of self-harm or suicide – it’s important to get professional help.

However, there is no need for a person to suffer through a less severe case of SAD – a primary care or mental health professional can still be of help.

Finding Help for SAD

“There are a lot of people who know that this time of year is hard for them, and they just suffer through the season knowing that spring is going to come and it’s going to get better. But anyone who’s struggling should talk to a health provider. There are ways to feel better,” said Dr. Adriance.

A primary care provider can help address many of the symptoms of depression and provide a referral to a mental health therapist if needed. You can also contact a mental health provider directly. A psychologist will thoroughly assess what is going on to establish a specific diagnosis.

Treatment recommendations for depression may include nutrition and lifestyle coaching, medication, psychotherapy, or a combination of these.

Light Therapy May Help

The unique thing about SAD is its connection to the season. “For a lot of people, the change in light is a big factor, especially here in the Northwest where the change is so dramatic. Light therapy can be very helpful for those people,” said Dr. Adriance.

You don’t need a prescription for light therapy, although people who also have bipolar disorder or eye problems like glaucoma and cataracts should consult with a health care provider before using a light therapy box. Light therapy lamps are not regulated by the FDA, so it’s important to choose carefully and speak with your doctor if you have questions or concerns.

The light should be manufactured specifically for SAD (there are also therapy lights for skin conditions that produce too much UV light) and should produce 10,000 lux. There is some evidence that exposure to bright light first thing in the morning is most effective, but it is generally safe to experiment to find what works best for you.

If you can afford it, that midwinter vacation to someplace warm and sunny is medically recommended. Dr. Adriance says that the combination of sunshine, socializing, nature, and physical activity can provide a reset to help you get through to spring.

Treatment and Prevention of SAD

Aside from light therapy, the treatment for SAD parallels the treatment for any kind of depression. As mentioned above, treatment for depression may include nutrition and lifestyle coaching, medication, psychotherapy, or a combination of these.

Many of the behaviors recommended for coping with seasonal depression are equally helpful for garden variety blues. When curling up in a blanket in front of tv feels hopeless instead of hygge, it’s time to get active.

“I recommend people schedule activities they enjoy,” said Lisa Adriance. She suggests participating in events with friends and family even if you don’t think you have the energy. Maintaining and strengthening your relationships with others supports both your mental and physical health year-round.

The Pacific NW offers part of the antidote to its own gloomy weather with ample opportunity for outdoor recreation. Planning to spend time outdoors in any weather can help prevent SAD.

“We live in a place where a lot of people make the most of where they live and they get outside and they do something, and that’s really key,” said Dr. Adriance.

Whether you hit the slopes or just take a walk, fresh air and exercise release endorphins that can improve your mood and energy level. Plus, even the pale, cloud-covered sunlight of a PNW winter is about twice as bright as typical indoor light levels. So, time outdoors is also a form of light therapy.

Happiness might not come as easily under cloud cover as it does when the days are bright and warm, and it might even need professional support, but taking small steps can help you be happier in winter.

If you’re suffering from SAD or chronic depression, WWMG’s primary care and mental health providers are here to help. Contact us to request an appointment today. We look forward to supporting you.